Disease of the Cerebrum Flashcards
Cerebrum
Consciousness, processing of sensory information (touch, pain, proprioception); skilled responses and motor function
Fascilitates the function of all cranial nerves
Thalamus
The relay center for all anatomic divisions of the brain
Other subcortical brain structures
Internal capsule, basal ganglia (caudate, putamen, globus pallidus)
Movement, congnition, emotion
Clinical Signs of Cerebral Syndrome
Gait abnormalities:
* weakness without ataxia
* Weakness with ataxia and deficits
* Proprioceptive deficits with normal strength
Conformation:
* Circling (“big” circles) and compulsive pacing
* Head turn, body turn
Seizures
Contralateral limb and vision deficits
Behavior changes (obtundation, head pressing, aggression)
Canine Distemper Encephalitis
Cerebrum, cerebellum, optic tracts, spinal cord
Canine distemper encephalitis:
Clinical signs
Blindness
seizures
central vestibular
Cerebellar
spinal cord
myoclonus
Hyperkeratosis of foot pads, gold-medalion lesions on retina
Canine Distemper Encephalitis
Diagnosis:
PCR (urine, conjunctival, pharyngeal, nasal, blood);
CSF - mononuclear pleocytosis and increased CDV IgG
Steroid-Responsive Meningitis Arteritis (SRMA)
AKA aseptic meningitis
#2 inflammatory CNS disease (#1 sterile inflammatory disease)
Young (8-18 mo), large breed dogs
SRMA
Clinical Signs
Neck pain
fever
Stiffness
Ataxia
SRMA
Diagnositics
CBC: Leukocytosis with left shift
CSF: Marked neutrophilic pleocytosis
Postive response to steroids
SRMA
Therapy
Immunosuppressive prednisone
SRMA
Beagle pain syndrome
Necrotizing polyarteritis
Frequently recurrent
Bacterial Meningitis, Encephalitis
Middle aged to older
Peracute, acute or gradual onset
Lethargy, reluctance to walk anorexia
Neck pain, hyperthermia, bradycardia, depression, seizures
Bacterial Meningitis, Encephalitis
Diagnosis
Elevated WBC, CSF tap (neutrophilic pleocytosis) + culture
Bacterial Meningitis, Encephalitis
Treatment
Antibiotics that cross the BBB (fluoroquinolones, 3rd gen. cephalopsporins, Trimethoprim-sulfa, chloramphenicol, doxycycline, macrolides)
Steroids for the first 24-48 hours may be beneficial at an anti-inflammatory dose
Fungal Meningoencephalitis
Cryptococcus, Histoplasmosis, Blastomycosis
Dog and Cat
Signs consistent with bacterial meningitis
Often a component of systemic disease
Funcdic exam: fungal plaques
Fungal Meningoencephalitits
Diagnosis
CSF
Urine antigen testing
Serology
Fungal Meningoecephalitis
Treatment
Fluconazole, Itraconazole
Amphotericin B
Posaconazole, Voriconazole (cats)
Meningeoncephalits of Unknown of Etiology (MUE or MUO)
Toy breeds, females, 1-8 years
Diffuse or coalescing lesions
MUO subsets
Granulomatous Meningoencephalitis
Ocular form: acute or subacute vision loss
Focal form: mass lesion
Disseminated form: multifocal signs
MUO subsets
Pug Dog Encephalitis (PDE)
Uncommonly seen today
Acute and chronic forms
Seizures, abnormal behavior, gait, posture
Circling, head tilt, head pressing, blindness
Femal pug, Fawn colored <7yrs
Genetic susceptibility testing available
MUO / GME / NME / PDE
Diagnosis
Suspicion based on clinical signs, signalment
CT, MRI
CSF: monoculcear to mixed pleocytosis, elevated protein
MUO / GME / NME / PDE
Therapy
Prendisone
Cyclosporine
Cytosine arabinoside
Leflunomide, Mycophenolate
Antiepileptics (PDE)
